- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $31.62 / $91.20
| Facility | | $25.70 | $31.62 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $19.05 / $30.20
| Professional | | $3.98 | $19.05 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $58.88
| Facility | | $33.11 | $33.11 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $22.39 / $36.31
| Professional | | $3.16 | $22.39 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $44.67 / $52.48
| Professional | | $41.69 | $44.67 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $20.42 / $26.30
| Facility | | $19.05 | $20.42 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $20.42 / $29.51
| Professional | | $6.17 | $20.42 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $40.74
| Facility | | $20.42 | $20.42 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $28.84
| Professional | | $20.42 | $20.42 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $28.18 / $58.88
| Facility | | $8.51 | $28.18 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $22.39 / $79.43
| Professional | | $6.17 | $22.39 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $60.26 / $81.28
| Facility | | $30.90 | $60.26 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $15.14 / $24.55
| Professional | | $4.68 | $15.14 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $24.55 / $32.36
| Facility | | $2.88 | $24.55 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $8.51 / $24.55
| Professional | | $2.57 | $8.51 | $24.55 |